Childhood functional urinary incontinence and school performance: a nationwide matched cohort study

TY - JOUR

T1 - Childhood functional urinary incontinence and school performance

T2 - a nationwide matched cohort study

AU - Borg, Britt

AU - Trabjerg, Betina B

AU - Dreier, Julie Werenberg

AU - Rittig, Søren

AU - Breinbjerg, Anders

AU - Christensen, Jakob

AU - Juul, Kristian

AU - Thomsen, Per Hove

AU - Kamperis, Konstantinos

PY - 2025/3/17

Y1 - 2025/3/17

N2 - PURPOSE: Childhood urinary incontinence is a common disorder with significant negative impact on self-esteem and quality of life, but the impact on school performance is unknown. This study investigates how urinary incontinence in children is associated with school performance.MATERIAL AND METHODS: Nationwide matched cohort study of children born in Denmark to Danish parents 1997-2008 investigating association between urinary incontinence and results from standardised National School Tests 2010-2018 (1-100 point scale). Multiple linear regression estimated difference (△) in test scores between children with urinary incontinence and matched references after adjusting for relevant confounders. Sub-analyses investigated the influence of psychiatric disorders and age at treatment onset.RESULTS: Overall, children with urinary incontinence (n=42,999) performed comparably to the matched reference children (n=429,999)(△ range -2.5 to +0.6 points).Children with urinary incontinence co-occurring with psychiatric disorders scored substantially lower than the reference population, most pronounced for ADHD (△ range -3.7 to -11.2 points).Children with nocturnal enuresis aged 11 years and above at treatment onset had lower overall school performance than children aged 5-7 years at treatment onset (△ -2.9 [95%CI -4.0 to -1.7]).CONCLUSIONS: School performance in children with urinary incontinence was normal. However, as psychiatric disorders are more prevalent in urinary incontinence and children with urinary incontinence and co-occurring psychiatric disorders had significantly lower school performance, we recommend assessing for psychiatric disorders in urinary incontinence. Children with late treatment onset had lower school performance than children with early treatment onset; further research is needed on the effect of delayed treatment on children with urinary incontinence.

AB - PURPOSE: Childhood urinary incontinence is a common disorder with significant negative impact on self-esteem and quality of life, but the impact on school performance is unknown. This study investigates how urinary incontinence in children is associated with school performance.MATERIAL AND METHODS: Nationwide matched cohort study of children born in Denmark to Danish parents 1997-2008 investigating association between urinary incontinence and results from standardised National School Tests 2010-2018 (1-100 point scale). Multiple linear regression estimated difference (△) in test scores between children with urinary incontinence and matched references after adjusting for relevant confounders. Sub-analyses investigated the influence of psychiatric disorders and age at treatment onset.RESULTS: Overall, children with urinary incontinence (n=42,999) performed comparably to the matched reference children (n=429,999)(△ range -2.5 to +0.6 points).Children with urinary incontinence co-occurring with psychiatric disorders scored substantially lower than the reference population, most pronounced for ADHD (△ range -3.7 to -11.2 points).Children with nocturnal enuresis aged 11 years and above at treatment onset had lower overall school performance than children aged 5-7 years at treatment onset (△ -2.9 [95%CI -4.0 to -1.7]).CONCLUSIONS: School performance in children with urinary incontinence was normal. However, as psychiatric disorders are more prevalent in urinary incontinence and children with urinary incontinence and co-occurring psychiatric disorders had significantly lower school performance, we recommend assessing for psychiatric disorders in urinary incontinence. Children with late treatment onset had lower school performance than children with early treatment onset; further research is needed on the effect of delayed treatment on children with urinary incontinence.

U2 - 10.1097/JU.0000000000004532

DO - 10.1097/JU.0000000000004532

M3 - Journal article

C2 - 40096666

SN - 0022-5347

SP - 101097JU0000000000004532

JO - The Journal of Urology

JF - The Journal of Urology

ER -